Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
CA 02430470 2007-08-07
1
NOVEL USE OF A PEPTIDE CLASS OF COMPOUND FOR TREATING
ALLODYNIA OR OTHER DIFFERENT TYPES OF
CHRONIC OR PHANTOM PAIN
Background of the invention
The present invention as broadly disclosed hereinafter relates to the novel
use
of a group of specific amino acid derivatives according to Formula I for the
preparation of pharmaceutical compositions useful for the treatment of
allodynia
as a major and unique pain symptom independent of the nature of an underlying
disease, but that is often related to neuropathic pain or other different
types of
chronic or phantom pain.
More particularly, the present invention as broadly disclosed relates to the
novel
use of harkoseride and its derivatives for the preparation of pharmaceutical
compositions useful for the treatment of allodynia as a major and unique pain
symptom independent of the nature of an underlying disease, but that is often
related to neuropathic pain, or other different types of chronic or phantom
pain.
The chemical name of SPfvt 927 which is also hereinafter referred to as
harkoseride is
(R)-2-Acetamido-N-benzyl-3-methoxypropionamide.
The compounds of the invention are known agents useful in antiseizure therapy
for central
nervous system disorders such as epilepsy, stroke and cerebral ischemia.
The instant invention concerns the novel use of a compound of Formula I below
for the
preparation of pharmaceutical compositions useful for the treatment of pain,
particularly
for the treatrnent of chronic pain disorders and especially for the treatment
of allodynia as
a major and unique pain symptom independent of the nature of an underlying
disease, but
that is often related to neuropathic pain conditions , or other different
types of chronic or
phantom pain and tinnitus aureum.
According to the invention compounds are those of Formula I
CA 02430470 2007-08-07
la
H H
I I
Ar-CH2NHC-C-N-C-Q1 (Formula I)
11 1 11
O CH2 O
Q
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-2-
or a pharmaceutically acceptable salt thereof wherein
Ar is phenyl which is unsubstituted or substituted with at least one halo
group;
Q is lower alkoxy containing 1-3 carbon atoms and Q, is methyl;
diastereomers and enantiomers of compounds of Formula I are included in the
invention.
Preferred compounds of the invention are those according to Formula I in which
the
compounds are an (R), (S), or (R,S) isomer.
The most preferred compound of the invention is (R)-2-Acetamido-N-benzyl-3-
methoxypropionamide or its pharmaceutically acceptable salt thereof.
Pain is a subjective experience and the perception of pain is performed in
particular parts
of the Central Nervous System (CNS).
Usually noxious (peripheral) stimuli are transmitted to the Central Nervous
System
beforehand, but pain is not always associated with nociception.
A broad variety of different types of clinical pain exists, that are derived
from different
underlying pathophysiological mechanisms and that will need different
treatment
approaches.
The perception of pain may be characterized by three major types of clinical
pain:
- acute pain
- chronic pain
- neuropathic pain
Acute clinical pain typically results from inflammation or soft tissue injury.
This type of pain
is adaptive and has the biologically relevant function of warning and enabling
healing and
repair of an already damaged body part to occur undisturbed. A protective
function is
achieved by making the injured/inflamed area and surrounding tissue
hypersensitive to all
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-3-
stimuli so that contact with any external stimulus is avoided. The neuronal
mechanisms
underlying this type of clinical pain are fairly well understood and
pharmacological control
of acute clinical pain is available and effective by means of e.g. Non-
Steroidal Anti-
Inflammatory Drugs (NSAIDs) up to opioids depending on type and extension of
the
sensation.
Chronic clinical pain appears as sustained sensory abnormalities resulting
from an
ongoing peripheral pathology such as cancer of chronic inflammation (e.g.
arthritis) or it
can be independent of the initiating triggers. The lafter being maladaptive,
offering no
survival advantage and very often no effective treatment is available.
Neuropathic pain is caused by injury or infection of peripheral sensory
nerves. It includes,
but is not limited to pain from peripheral nerve trauma, herpes virus
infection, diabetes
mellitus, causalgia, plexus avulsion, neuroma, limb amputation, and
vasculitis.
Neuropathic pain is also caused by nerve damage from chronic alcoholism, human
immunodeficiency virus infection, hypothyroidism, uremia, or vitamin
deficiencies.
Neuropathic pain includes, but is not limited to pain caused by nerve injury
such as, for
example, the pain diabetics suffer from.
Neuropathic pain shows two different pathophysiological mechanisms which have
to be
considered:
First, enhanced activity of afferent nociceptive neurons following
sensitisation of (sleeping)
neurons (e.g., inflammatory pain, cancer pain, headache, lower back pain,
visceral pain,
migraine) with the primary afferent nociceptive neuron remaining intact,
though the
receptor activity is changed and reduced thresholds, increase of firing rates
and starting of
or increase of spontaneous activity are typically found.
Second, ectopic activity of afferent nociceptive neurons following lesions of
its axons (e.g.,
peripheral and central neuropathic pain), with the primary afferent neuron
being damaged.
This leads to irreversible peripheral and central biochemical, morphological
and functional
changes. Therefore, (peripheral) neuropathy is broadly defined as a disease of
the
(peripheral) nervous system.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-4-
There are several causes of human neuropathy with considerable variability in
symptoms
and neurological deficits. Painful neuropathies are defined as neurological
disorders
characterised by persistence of pain and hypersensitivity in a body region, of
which the
sensory innervation has been damaged, but damage to sensory nerves does not
always
produce neuropathic pain, usually loss of sensation rather than
hypersensitivity or pain
are observed.
Specific somatosensory disorders are referred to as allodynia (innocuous
somatosensory
stimulation evokes abnormal intense pain sensation with an explosive,
radiating character
often outlasting stimulus duration like a trigger), hyperalgesia (noxious
stimulation evokes
more intense and prolonged pain sensations), paresthesia (spontaneous aversive
but
nonpainful sensations, described as tingling or "pins and needles"),
dysesthesia (evoked
as well as spontaneous abnormal sensations).
Several key events are agreed in as common pathophysiological events of
abnormal pain
states particularely following peripheral nerve injury. Thus, high frequency
spontaneous
discharge from ectopic site is followed by an increased responsiveness of
dorsal horn
neurons and expansion of the receptive field, often defined as central
sensitisation.
Common analgesics like opioids and non-steroidal anti-inflammatory drugs
(NSAIDs)
improve only insufficiently chronic abnormal pain syndromes. In the search for
alternative
treatment regimes to produce satisfactory and sustained pain relief,
corticosteroids,
conduction blockade, glycerol, antidepressants, local anesthetics,.
gangliosids and
electrostimulation have been tried, but mainly anti-convulsants have been
found useful
against various types of neuropathic pain conditions, but appear to be most
effective in
cases of paroxysmal, lancinating events, e.g. trigeminal neuralgia.
If general overactivity and unleaded low threshold activation of sensory
neurons is
considered as one of the main syndromes of neuropathy and neuropathic pain
sensation
with a marked mechanoallodynia as the most disabling clinical sympton,
selective
inhibition of this pathophysiological event instead of general inhibition of
high threshold
noxious stimuli (by e.g. local anesthetics) of the normal sensory nociception
provides clear
advantages.
CA 02430470 2007-08-07
The condition listed above are known to be poorly treated by currently
marketed
analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAID's)
due to insufficient efficacy or limiting side effects.
Thus, the present invention is directed to a novel use of a compound according
to the aforementioned Formula I or one of its derivatives for the preparation
of a
pharmaceutical composition for the treatment of allodynia or phantom pain. The
invention as claimed is however restricted to the use of such a compound for
the
preparation of a composition for the treatment of phantom pain exclusively.
The invention as claimed is also directed to a novel use of the same compound
or the derivatives for the preparation of a pharmaceutical composition useful
for
the treatment of tinnitus aureum.
One of the preferred compounds is the one called "Harkoseride", which chemical
name is (R)-2-Acetamido-N-benzyl-3-methoxypropion-amide is one derivative
selected of the group of specific amino acid derivatives.
This group of substances is disclosed in US 5,378,729; US 5,654,301 and
5,773,475.
They show activity for the treatment of epilepsy and stroke. But there is no
disclosure in
the above references to make obvious the present invention.
The compounds of the present invention may form pharmaceutically acceptable
salts with
both organic and inorganic acids or bases.
For example, the acid addition salts of the basic compounds are prepared
either by
dissolving the free base in aqueous or aqueous alcohol solution or other
suitable solvents
containing the appropriate acid and isolating the salt by evaporating the
solution.
Exaniples of pharmaceutically acceptable salts are hydrochlorides,
hydrobromides,
hydrosulfates, etc. as well as sodiurn, potassium, and magnesium, etc. salts.
Ttie compourids of the present invention can contain one or several
assymmetric carbon
atoms. The inventiori includes the individual diastereomers or enantiomers,
and the
07-02-2003
CA 02430470 2003-05-30 EP0203032
Y a -6-
mixtures thereof. The individual diastereomers or enantiomers may be prepared
or
isolated by methods already well-knwon in the art.
According to the invention it is preferred that the compounds are in the (R)-
configuration.
It is preferred that the compounds are substantially enantiopure. Most
preferred is=the
compound (R)-2-Acetamido-N-benzyl-3-methoxypropionamide.
= The compounds of this invention may be synthesized as disclosed in the
documents U.S.
P 5,378,729; U.S. P 5,654,301 and U.S. P 5,773,475.
The compounds made by the synthetic methods can be used as pharmaceutical
compositions as agent in the treatment of pain when an effective=amount of a
compound
of the Formula I, together with a pharmaceutically acceptable carrier is used.
The
pharmaceutical can be used' in a method for treating such disorders in
mammals,
including human, suffering therefrom by administering to such mammals an
effective
amount of the compounds described above in unit dosage form.
The pharmaceutical compound, made in accordance with the present irivention,
can be
prepared and administered in a wide variety of dosage forms by either oral or
parenteral
routes of administration. For example, these pharmaceutical compositions can
be made in
inert, pharmaceutically acceptable carriers which are either solid or liquid.
Solid form
preparations include powders, tablets, dispersible granules, capsules,
cachets, and
suppositories. Other solid and liquid form preparations could be made in
accordance with
known methods of the art and administered by the oral route in an appropriate
formulation, or by a parenteral route such as intravenous, intramuscular, or
subcutaneous
injection as a liquid formulation.
The quantity of active compound in a unit dose of preparation may be varied or
adjusted
from about 1 mg to about 2 x 300 mg per day per patient. A daily dose range of
about
1 mg to about 300 mg is preferred. The dosages, however, may be varied
depending
upon the requirement with a patient, the severity of the condition being
treated, and the
compound being employed. Determination of the proper dosage for particular
situations is
within the skill of the art.
AMENDED SHEET
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-7-
The'following working examples selected from specific animal models show the
anti-
neuropathic pain activity of harkoseride and its derivatives in general and
the antiallodynia
efficay of harkoseride and its derivatives in particular.
1. Example 1:
Formalin test, rat
Significant and dose dependent efficacy of harkoseride could be demonstrated
in the late
phase of the rat formalin test.
The formalin test is a chemically-induced tonic pain model in which biphasic
changes of
nociceptive behaviour are assessed and spinal/supraspinal plasticity of
nociception is
considered as a molecular basis for neuropathic pain particularly during the
second (=late)
phase of the test, during which most clinically used drugs against neuropathic
pain are
active. These features have resulted in the formalin test being accepted as a
valid model
of persistent clinical pain.
The compound was tested for anti-nociceptive properties by use of the weighted
behavioural scoring method: Freely moving animals underwent observational
assessment
of the position of the left hind paw according to a rating score scaled 0-3
before and 10,
20, 30 and 40 min after injection of 0.05 ml of sterile 2.5% formalin under
the skin on the
dorsal surface of the paw. Harkoseride, administered i.p. just prior to
formalin injection
produced dose dependant reduction of the formalin-induced tonic inflammatory
nociceptive behaviour as shown in table 1 (weighted pain scores SEM, n=11-
12/group).
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-8-
Table 1: Weighted pain score, formalin test, rat
Time After Injection of formalin and SPM 927
Dose No. of
[mg/kg] Animals BASELINE 10 MIN 20 MIN 30 MIN 40 MIN
0 11 0.00 0.00 0.30 0.16 0.93 0.21 1.84 0.19 2.10 0.24
12 0.01 0.01 0.31 0.11 0.78 0.23 1.47 0.20 1.46 0.19*
11 0.00 0.00 0.42 0.17 0.33 0.16* 1.02 0.27* 1.05 0.19*
12 0.00 0.00 0.48 0.18 0.57 0.14 0.78 0.18* 1.02 0.24*
40 12 0.00 0.00 0.12 0.05 0.10 0.04* 0.09 0.06* 0.12 0.06*
*= Significant difference from vehicle (ANOVA corrected for multiple
comparisons
5 p_0.05.
The term ANOVA stands for Analysis of Variance.
These results support and confirm the hypothesized anti-neuropathic pain
activity of the
compound.
Data reported here support and give the necessary scientific basis for the
activity
observed earlier in the writhing test and the mouse formalin test. The former
data being
limited due to the fact that the writhing test is considered a very unspecific
test with some
tonic chemically-induced nociceptive aspects that usually gives positive
results for all
psychoactive drug muscle relaxants etc. therefore not being specific enough to
claim
specific activity. In addition, the former results obtained in the mouse
formalin test, lacks
clear evidence of dose relationship and therefore specificity of the observed
effects for
harkoseride. Furthermore, the only and highest dose giving significant effects
in the first
investigation already was found to cause clear behavioral side effects.
Therefore, these
drugs include changes in behavior, these drug-related changes cannot be
claimed as
antinociceptive any longer.
Therefore, only the newly reported data provided here can be considered an in
vivo
proven antinociceptive effect of harkoseride, with dose dependency serving as
measure of
specificity and improvement of antinociceptive behavior as being unrelated to
toxic effects.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-9-
Example 2:
Chronic constriction injury (CCI, Bennett-model)
The effectiveness of harkoseride in reducing spontaneous chronic pain,
mechanical
allodynia, and thermal hyperalgesia was tested using the chronic constriction
injury (CCI)
model of peripheral neuropathy, one of the best characterised in vivo animal
models used
to study chronic pain due to peripheral nerve injury. In this model, loose
ligatures are
placed around the sciatic nerve, which produces axonal swelling and a partial
10. deafferentation manifested as a significant but incomplete loss of axons
in the distal
portion of the peripheral nerve. One of the prominent behaviours seen
following sciatic
nerve ligation is the appearance of hind paw guarding, thought to be an
indication of an
ongoing spontaneous chronic pain. Support for this idea is derived from
reports of
increased spinal cord neural activity, and increased spontaneous neuronal
discharge in
spinothalamic tract neurons and in the ventrobasal thalamus in the absence of
overt
peripheral stimulation. In addition to the appearance of spontaneous pain
behaviours,
several abnormalities in stimulus evoked pain occur as a result of CCI,
including thermal
hyperalgesia and mechanical allodynia. The development of these abnormal
stimulus-
evoked pains has also been reported as occurring in areas outside the
territory of the
damaged nerve, areas innervated by uninjured nerves.
Behavioural tests for spontaneous pain, thermal hyperalgesia, and mechanical
allodynia
were conducted to evaluate different components.of neuropathic pain. Baseline
data for
each test was collected prior to any experimental procedure; in addition, all
animals were
tested for the development of chronic pain behaviours 13-25 days after CCI
surgery 1 day
prior to the day of vehicle (0.04 ml sterile water /10 g body weight) or drug
administration
and after vehicle/drug administration. The sequence of the tests was (1)
spontaneous
pain-related behaviour (2) mechanical allodynia, (3) thermal hyperalgesia in
order to
minimise the influence of one test on the result of the next. The testing
procedures and
results are presented separately for each aspect of chronic pain. Either 0
(vehicle, 0.04
mi/10g body weight), 5, 10, 20 or 40 mg/kg of SPM 927 (n=7-23/group) was
administered
i.p. 15 minutes before the first behavioural test.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-10-
Spontaneous pain (ongoing pain without an apparent external stimulus) of the
ligated paw
was assessed for 5 min following a 10 min acclimation period by use of a
rating score
(weighted behaviour score scaled 0-5).
Harkoseride did not change the level of spontaneous pain induced by unilateral
chronic
constriction injury as shown in table 2 (weighted pain scores SEM).
Table 2: Spontaneous nociception, CCI model, rat
Dose No. of
[mg/kg] Animals Baseline Post-op Post-op + Drug
0 23 0 0 1.4 0.15 1.2 0.14
5 9 0 0 2.0 0.10 1.8 0.18
20 0.0019 0.0019 1.5 0.10 1.5 0.11
8 0 0 1.1 0.17 0.9 0.14
40 10 0.0004 0.0004 1.3 0.12 0.8 0.28
Thermal hyperalgesia was assessed by means of withdrawal latency in response
to
radiant heat applied to the subplantar surface of the ligated rat hind paw. As
compared to
the baseline latency (s), a significant decrease in the (postoperative)
latency of foot
withdrawal in response to the thermal stimulus was interpreted as indicating
the presence
of thermal hyperalgesia following chronic constriction injury.
Harkoseride dose dependently reduced chronic constriction injury-induced
thermal
hyperalgesia as shown in table 3 [latencies (s) SEM]. Significant effects
were observed
only at the highest doses tested (20 and 40 mg/kg i.p.) with the maximum
effect seen
already at 20 mg/kg i.p.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-11-
Table 3: Thermal hyperalgesia, CCI model, rat
Dose No. of
[mg/kg] Animals Baseline Post-op Post-op + Drug
0 13 9.8 0.74 7.0 0.29 7.3 0.43
7 10.5 0.68 8.1 0.59 9.2 0.98
7 9.2 0.68 7.1 0.60 8.1 0.59
8 10.0 0.70 7.0 0.56 9.7 0.96*
*
40 8 8.3 0.57 7.4 0.48 10.2 0.75
*= Significant difference from vehicle (ANOVA corrected for multiple
5 comparisons p <_ 0.05.
Mechanical sensitivity and allodynia of the ligated rat hind paw was
quantified by brisk foot
withdrawal in response to normally innocuous mechanical stimuli as described
previously.
Responsiveness to mechanical stimuli was tested with a calibrated electronic
Von Frey
10 pressure algometer connected to an online computerised data collection
system. A
significant decrease in the post operative compared to baseline pressure
(g/mm2)
necessary to elicit a brisk foot withdrawal in response to this mechanical
stimulus is
interpreted as mechanical allodynia.
15 Harkoseride dose dependently reduced the intensity of mechanical allodynia
induced by
unilateral nerve ligation as shown in table 4 [pressure (g/mm2) SEMI.
Regression
analysis showed a positive linear correlation between the dose of Harkoseride
and the
increase in the amount of force required to produce foot withdrawal
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-12-
Table 4: Mechanical allodynia, CCI model, rat
Dose No. of
[mg/kg] Animals Baseline Post-op Post-op + Drug
0 20 41.6 2.20 18.8 2.09 20.2 1.90
11 53.6 3.35 16.4 2.56 21.8 2.34
17 42.9 2.55 21.2 2.13 29.2 2.85 *
8 46.1 2.62 24.7 2.78 39.6 3.62 *
40 9 48.4 3.84 23.9 2.23 43.0 5.48 *
Significant difference from vehicle (ANOVA corrected for multiple
5 comparisons, p <_ 0.05).
These results support and confirm the hypothesised anti-allodynia efficacy of
Harkoseride.
Furthermore this effect is additionally related to neuropathic pain and
therefore supports
the potential clinical use of the compound by mimicking the clinical situation
of symptom
10 related treatment as close as possible..
Further proof of specificity of the anti-allodynia effect of harkoseride was
given by negative
results in the tail flick test excluding typical opioid-like analgesia of the
compound. The
former data obtained in mice could be repeated and confirmed in a second
species, the
15 rat, by additional means of more appropriate choice of the doses tested:
Example 3
Tail flick test, rat
20 Harkoseride was additionally tested for potential activity in acute spinal
thermal
nociception using the tail flick test. In this model of acute thermal
spinal/reflex
hyperalgesia radiant heat is applied to the animal's tail approximately 2 cm
from the tip
and time latency for withdrawal reaction is automatically assessed by an
algometer, a
defined maximal' stimulus time prevents tissue damage. This test is widely
used as an
assay for the anti-nociceptive efficacy of pharmacological agents and is
highly predictive
of acute analgesic efficacy in humans. Usually pure analgesics of the opioid
type are most
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-13-
active; neither adjuvants like amitryptiline nor anti-epileptics nor NSAIDs
(non-steroidal
anti-inflammatory drugs) are active.
Results for 20 and 40 mg/kg harkoseride i.p are shown in table 5 [percent anti-
nociception, calculated as [{(post-drug latency) -(pre-drug-latency)}/{(max.
latency) - (pre-
drug latency)} x 100] SEM, n=12/group]. A baseline or pre-drug tail-flick
latency was
determined by averaging 5 consecutive measurements taken 2 minutes apart.
Vehicle
(sterile water 0.04m1/10g body weight) or harkoseride were then administered
and tail flick
latencies recorded at 10-minute intervals for the next 60 minutes. Even at
doses giving
maximum effect in the rat formalin test (see above), harkoseride had little or
no effect on
the latency of the tail flick reflex.
Table 5: Acute thermal hyperalgesia, tail flick, rat
Anti-nociceptive effect [%] of different doses [mg/kg] of i.p.
Harkoseride
Time after -
0 20 40
SPM 927[min]
10 -2.1 3.08 5.0 3.94 -1.6 12.82
-0.5 3.19 9.7 7.51 -4.3 14.04
4.4 4.71 9.7 2.37 -2.3 9.14
10.4 5.91 1.7 7.42 -4.4 11.44
7.6 4.58 5.4 4.12 0.3 15.50
7.4 6.07 8.1 5.20 -5.5 14.11
Therefore no anti-nociceptive effect of harkoseride was detectable in the tail-
flick test, this
supports the hypothesised profile of harkoseride with higly specific anti-
allodynia
properties and not being active in conditions of acute pain.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-14-
Example 4
The anti-nociceptive activity of harkoseride in comparison with gabapentin
In the following explained study the used harkoseride is hereinafter
abbreviated as SPM
927 and gabapentin is hereinafter abbreviated as GBP.
OBJECTIVE:
The major aim of this study was to assess the anti-nociceptive activity of SPM
927 and
gabapentin (GBP) in rodent models for inflammatory pain and to compare the in
vivo
effects of each drug with each other.
METHODS:
Carrageenan-induced mechanical hyperalaesia in rats was induced by subplantar
injection of a 0.1 ml of a 2% carrageenan suspension and measured 3h
afterwards by the
paw pressure (Randall-Sellito) test.
Subchronic inflammatory nocicpetion in mice was induced by the subplantar
injection of
formalin (0.02ml of a 5% solution). Nociceptive behaviour (paw licking) was
measured and
quantified between 0 and 5min (acute pain) and between 20 and 30min
(subchronic
inflammatory pain) after formalin.
Drugs and experimental design: SPM 927 and GBP were suspended in 1%
methylcellulose and administered i.p. at doses of 10mg/kg, 20mg/kg and
40mg/kg. Pre-
treatment time was 30min before pain measurement. One group of animals served
as
controls and consequently received an injection of solvent (10ml/kg) and
another group of
animals received a reference compound (Carrageenan test: 10mg/kg indomethacin;
Formalin test: 10mg/kg morphine). Each compound was tested in a separate
experiment
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-15-
and each experiment included a control and a reference group. 10 rats per
group were
used in the Carrageenan test and 6 mice per group in the formalin test.
RESULTS:
Carrageenan-induced mechanical hyperalgesia in rats: Results are summarized in
the
following table 6.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-16-
~ ~. cc~ LO
N
Q) CD +1 a) C) +1 U)
ai cn
~ F
~ 00 ~ u CY)
'O 0
c\j co CY) U) O
cri cY)
~. d~u ~ N o
nI) N V
C Q-
fl..
o
c~ O C4 ~- M E(D
C/) m N tr_
CL
O
N LO O N
r - d! LO
.~
(n ~J N
~ c
0 O
~ M
O Q ~
W ~
U T ~ , T Q
U
+I E ~ +I E 0
Ll:=1 ''- a :
p c~ c
C r ~ , (V =-
~ ? . _ O O
U
C O
N ,..
E LA {_ 'a
~
V -5 "3: +1 +1
_ cz Co
W ~ ci ai ~;~
>cO > 0 c 3)
~
~'~ cn
(D Q~ ~
Q) UC/) Ucn U
0
~ cts
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-17-
In all three experiments,significant mechanical hyperalgesia developed as
shown by
significant differences in the nociceptive'threshold in the inflamed as
compared to the non-
inflamed paw.
All doses of SPM 927 resulted in a full reversal of Carrageenan-induced
mechanical
hyperalgesia.
The antinociceptive of SPM 927 was comparable to that of the reference
compound
Indomethacin.
GBP had no significant effect on Carrageenan induced mechanical hyperalgesia
at the
doses tested.
Subchronic inflammatory nociception in mice (formalin test): Results are
summarized in
the following table 7.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-18-
+r
cn
(D
~.-.
cf)
ci) aD
ro (Z E
aD
CO ~
(fl O
Q ~, ~}~j ~- +I +I
u;, T O O
O
O
0
v
CL
N cTS 0 cf) n.
O=..., oo T 1-~ .. T T O
~ +I +I p., +I +I I-
~ ~
CI T V ~ ~
co
(D
t~11 CO O 11 Co c0)
0) O -" +I +I N +I +1
~ N a N ~ >
... ,
1--.~ 0
O O
N LO C.0 0
T
T
+1 +I c)I ~
O
U
c~ :--- E
}I ,U . v
Z + d) ~ CO r
W ao W o T
~
a)
co
LL ~ ~ CZ
> u > u (a
a)
co
Q~ U) fn U
U O U O
B O O
~ ~ ~ ~ co
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-19-
A clear nociceptive response was induced by formalin. SPM-927 dose dependently
suppressed the nociceptive response. The efficacy of SPM 927 was similar to
that of
morphine i.e. a near complete reversal of the formalin-induced nociception.
GBP slightly
but not significantly inhibited the nociceptive response induced by formalin
Example 5
The following Tables 8 and 9 show the effects of harkoseride (hereinafter
referred to as
SPM 927), carbamazepine, levetiracetam, gabapentin and morphine in the
neuropathic
pain (CHUNG) test in the rat. Eight (8) rats per group were used.
Table 8 shows the examined effects by tactile stimulation on lesioned paw.
Table 9 shows the examined effects by thermal stimulation on lesioned paw.
In general, all compounds showed more pronounced effects on tactile
nociceptive
stimulation than on thermal nociceptive stimulation, and SPM 927 was minimum
comparable, but usually more potent than the reference compounds.
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-20-
TABLE8
EFFECTS OF SPM 927, CARBAMAZEPINE, LEVETIRACETAM
GABAPENTIN AND MORPHINE
IN THE NEUROPATHIC PAIN (CHUNG) TEST
IN THE RAT
(8 RATS PER GROUP)
TACTILE STIMULATION
(Iesioned paw)
TREATMENT FORCE INDUCING PAW-WITHDRAWAL
(mg/kg) (g)
i.p. -30 min
mean s.e.m. p % change
value
Sham control 63.3 4.5 - -
Lesioned control 17.4 2.2 *** (a) 0.000 -73% (a)
- -- - --------------- ---
SPM 927 (8) 27.2 4.9 NS (b) 0.094 +56% (b)
SPM 927 (16) 24.4 3.0 NS (b) 0.086 +40% (b)
SPM 927 (32) 37.6 6.1 ** (b) 0.008 +116% (b)
Carbamazepine 21.0 2.3 NS (b) 0.275 +21 % (b)
(16)
Carbamazepine 38.4 8.1 * (b) 0.026 +121 % (b)
(32)
Carbamazepine 39.2 9.1 * (b) 0.036 +125% (b)
64~- - - - - - - ----- -------- ---------------- ------------- ----------------
-----------
Levetiracetam 23.0 4.0 NS (b) 0.243 +32% (b)
(16)
Levetiracetam 25.0 5.2 NS (b) 0.199 +44% (b)
(32)
Levetiracetam 19.8 4.1 NS (b) 0.612 +14% (b)
(64) - - - ---- ----------- ------- -------------------------------------------
--- -- -- -
Gabapentin (32) 17.2 3.0 NS (b) 0.959 -1 % (b)
Gabapentin (64) 23.5 4.2 NS (b) 0.219 +35% (b)
Gabapentin (128) 33.6 6.7 * (b) 0.038 +93% (b)
Morphine (16) 45.9 8.8 * (b) 0.007 +164% (b)
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-21-
Student's t test (non-paired) : NS = Not Significant; *= p < 0.05; ** = p <
0.01;
***=p<0.001
(a) compared with sham control
(b) compared with lesioned control
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-22-
TABLE 9
EFFECTS OF SPM 927, CARBAMAZEPINE, LEVETIRACETAM
GABAPENTIN AND MORPHINE
IN THE NEUROPATHIC PAIN (CHUNG) TEST
IN THE RAT
(8 RATS PER GROUP)
THERMAL STIMULATION
(lesioned paw)
TREATMENT PAW-WITHDRAWAL LATENCY
(mg/kg) (sec)
i.p. -30 min
mean s.e.m. p % change
value
Sham control 40.6 2.2 - -
Lesioned control 16.3 4.4 *** (a) 0.000 -60% (a)
SPM 927 (8) 26.1 5.4 NS (b) 0.180 +60% (b)
SPM 927 (16) 16.8 4.5 NS (b) 0.933 +3% b)
SPM 927 (32) 21.1 5.6 NS (b) 0.512 +29% (b)
Carbamazepine 35.6 4.1 ** (b) 0.006 +118% (b)
(16)
Carbamazepine 22.7 4.3 NS (b) 0.315 +39% (b)
(32)
Carbamazepine 28.8 6.9 NS (b) 0.147 +77% (b)
(64) -- ---- ------- ---- -----------------------
Levetiracetam 19.0 3.6 NS (b) 0.641 +17% (b)
(16)
Levetiracetam 17.1 2.9 NS (b) 0.882 +5% (b)
(32)
Levetiracetam 26.6 6.0 NS (b) 0.187 +63% (b)
~64) -- - - -- ------------- --_
Gabapentin (32) 19.3 3.6 NS (b) 0.611 +18% (b)
Gabapentin (64) 28.5 5.4 NS (b) 0.101 +75% (b)
Gabapentin (128) 27.1 5.2 NS (b) 0.135 +66% (b)
Morphine (16) 42.4 1.9 *** (b) 0.000 +160% (b)
CA 02430470 2003-05-29
WO 02/074297 PCT/EP02/03032
-23-
Student's t test (non-paired) : NS = Not Significant; *~ = p < 0.01; ** ~= p <
0.001
(a) compared with sham control
(b) compared with lesioned control
